the groundon Earth and holds the planets in their orbits (paths)around the Sun. The force of gravity acts over immensedistances between objects in the universe and holdsthem all together. The gravitationalforce between objects increases withtheir MASS. It also increases thecloser they are. The gravitybetween objects on Earth isusually too small to observebreathing stoppage.Treatment of apnoea depends on thecause. In newborn babies, it resolves asthey mature. In stroke or head injury,artificial ventilation may be neededtemporarily until recovery occurs.apocrine gland A gland that dischargescellular material in addition tothe fluid it secretes. The term is usuallyapplied to the type of sweat glands thatappear in hairy body areas after puberty.(See also eccrine gland.)apolipoprotein A group of proteinsthat are constituents of lipoproteins, thecarriers of fat in the bloodstream. Apolipoproteinsare also involved in thegrowth and repair of nerve tissues.aponeurosis A wide sheet of tough,fibrous tissue that acts as a tendon,attaching a muscle to a bone or a joint.apophysis An outgrowth of bone at thesite of attachment of a tendon to bone.Inflammation may also occur, as inOsgood–Schlatter disease.apoplexy An outdated term for a stroke.apoptosis The natural process of programmedcell death. Apoptosis occursin embryonic development, when theshaping of body parts is taking placeand continues throughout life in theconstant cycle of death and renewal ofbody cells. Failure of apoptosis is implicatedin the development of cancers.apothecary An old term for a pharmacist.appendicectomy Surgical removal of theappendix to treat acute appendicitis.appendicitis Acute inflammation of theappendix. The cause is usually notknown, but appendicitis is sometimescaused by obstruction of the appendixby a lump of faeces. The 1st symptom isusually vague discomfort around thenavel. Within a few hours, this developsinto severe, more localized pain, which isusually most intense in the lower righthandside of the abdomen. Symptomsmay differ if the appendix is not in themost common position. For example, ifthe appendix impinges on the ureter,the urine may become bloodstained.The usual treatment for appendicitisis appendicectomy, which is often performedendoscopically (see minimallyinvasive surgery). If the treatment is

delayed, an inflamed appendix mayburst, releasing its contents into theabdomen. This leads to peritonitis and,in some cases, an abscess.appendix A small, narrow tube thatprojects out of the caecum (the 1st partof the colon) at the lower right-handside of the abdomen. It may lie behindor below the caecum, or in front of orbehind the ileum (part of the smallintestine). The appendix has no knownfunction, but it contains a large amount

of lymphoid tissue which provides aACCELERATIONKING, MARTIN LUTHERIN THE LONG FIGHT of black Americans forequal rights, one man stands out for his greatcommitment to racial equality. Martin LutherKing was a Baptist Church minister whose Christian faithinformed all his work. He believed in non-violent protest asa way of obtaining change, and led many sit-ins, marches,and voter registration campaigns. King was an inspiredspeaker, whose words gave hope to millions. Hisassassination in 1968 dashed many of those hopes.Civil rights movementBlack Americans were given equal rights under the US Constitution,but were still treated as second-class citizens in many southernstates. Local state laws denied black Americans the right to vote orgo to multiracial schools. Black and white people were segregated(kept apart) and even had to sit in different seats on buses. Blackprotests led to a growing civil rightsmovement in the 1950s and 1960s.King emerged as the charismaticleader of this movement.

Early lifeMartin Luther King Jr wasborn in Atlanta, Georgia, inthe southern USA, on 15January 1929. King's fatherwas a prominent Baptistminister, inspiring his sonto follow him into thechurch to study theology.King received his doctorateof theology in 1955.Bus boycottOn 1 December 1955, Rosa Parks,a black woman, refused to give upher seat on a bus to a white man inMontgomery, Alabama, and wasarrested for violating the ciryssegregation law. Black residents, ledby King and Rev Ralph Abcrnathy,encouraged a boycott of the ciry sbuses that led to their desegregation.

Malcolm XMany black people disagreedwith King's aim of fullintegration of black and

white, preferring to aim forblack separatism. Their leaderwas Malcolm X, who was amember of the Black Muslimmovement led by ElijahMuhammad. He laterconverted to orthodox Islam,and took up the cause ofracial unirv.Sit-insA favoured tactic of civil rights campaignerswas to stage sit-in demonstrations insegregated restaurants and other public places.In 1960 King was arrested at a segregatedlunch counter in an Atlanta department store-He was sent to prison, and was only releasedafter the intervention of the Democraticpresidential candidate, John F. Kennedy-Freedom ridesIn I 961, black and white civil rights protestersdefied state segregation laws by travellingtogether on segregated buses. The governmentsent in national guardsmen to protect theriders. This led to increased racial tension andactivity by the racist Ku KJux Klan, who carriedflaming crosses in marches in southern USA.Little RockIn 1957, the governor ofArkansas refused to admit nineblack children to the all-whiteLittle Rock Central High School.Ptesident Eisenhower sent 1,000paratroopers and 10,000 nationalguardsmen to protect thechildren as they went to school.

"I have a dream"On 28 August 1963, King ledthe historic March onWashington to demand civilrights reform. More than200,000 marchers heard hiswords: "I have a dream thatone day this nation will rise upand live out the true meaningof its creed: 'We hold thesetruths to be self-evident, thatall men are created equal'".Birmingham JailKing went to jail many times for hisbeliefs. During a period in jail inBirmingham, Alabama, in Spring 1963,he wrote an eloquent letter outlininghis philosophy of non-violent protest.He was inspired in this policy by theIndian leader Mohandas K. Gandhisnon-violence campaign against Britishrule in India, the movement known asvitv.i!:r.ih;l 'devotion ro t r u t h l .

MARTIN LUTHER KING1929 Born in Atlanta, Georgia.1951 Receives Bachelor of DivinityAssassinationThe last years of King's life were markedby increasing disputes with more radicalblack leaders who disagreed with hisnon-violent approach. In April 1968, he\-isited Memphis, Tennessee to offersupport to striking city sanitationworkers; he was assassinated at the motelwhere he was staying on 4 April. Protestriots broke out in most major US cities.1954 Becomes pastor of BaptistChurch in Montgomery, Alabama.I960 President of the Southern

Christian Leadership Conference;sent to prison for his part in a sitinin Atlanta.1963 Spells out his doctrine ofnon-violent protest; leads marchon Washington.1964 Awarded j>Jobel Peace^Prize.1968 Assassinated in Memphis,Tennessee.

MFINOD ROUET HRUIGMHATNS SLAVERY SOCIETIES,HUMAN

UNHIITSETODR SAbuse is a complex psychosocial problem that

affects large numbers of adults as well as children

throughout the world. It is listed in the Diagnostic and

Statistic Manual of Mental Disorders (DSM-IV-TR)

under the heading of “Other Conditions That May Be a

Focus of Clinical Attention.” Although abuse was first

defined with regard to children when it first received sustained

attention in the 1950s, clinicians and researchers

now recognize that adults can suffer abuse in a number of

different circumstances. Abuse refers to harmful or injurious

tlude not

only the direct costs of immediate medical and psychiatric

treatment of abused people but also the indirect

costs of learning difficulties, interrupted education,

workplace absenteeism, and long-term health problems

of abuse survivors.

Types of abuse

Physical

The Abnormal Involuntary Movement Scale (AIMS)

is a rating scale that was designed in the 1970s to measure

involuntary movements known as tardive dyskinesia

(TD). TD is a disorder that sometimes develops as a

side effect of long-term treatment with neuroleptic

(antipsychotic) medications.

Purpose

months to monitor the patient for the development of TD.

For most patients, TD develops three months after the initiation

of neuroleptic therapy; in elderly patients, however,

TD can develop after as little as one month.

Precautions

The AIMS test was originally developed for administration

by trained clinicians. People who are not health

care professionals, however, can also be taught to administer

the test by completing a training seminar.

DescriptionWater is one of the most powerful forces scraping and shapingthe Earth’s surface. Whether in its liquid form or as ice, watercarves out valleys, wears away coastlines, and carriesparticles of rock down rivers and across oceans. If waterbreaks rock down into particles where it stands, theprocess is called weathering. If water wears rockaway and carries its particles from one place toanother, the process is known as erosion. Pillars of weathered rockThese strangely shaped pillars are known as hoodoos.Made of soft limestone rock, capped by harder rock, theyare shaped by frost and rain. In winter, frost and ice crackthe rocks. In warmer weather, rainwater, which is slightlyacidic, slowly dissolves the limestone and rounds thehoodoo’s edges to create this shape.Rivers of snow and iceWhen snow and ice settle on high ground, gravitygradually pulls them down along any valleys. This formsa flowing “river” of ice, called a glacier. The moving iceenters cracks in the rock, dislodges rocky chunks, andwears away the bottom and sides of the valley.Ice and frostRainwater or melting snow seep into cracksin any exposed rock. If this water freezes, it

expands and creates wedges of ice. Thesecan cause enormous damage, prising anycracks wider and splitting the rockAbuse is a complex psychosocial problem that

affects large numbers of adults as well as children

throughout the world. It is listed in the Diagnostic and

Statistic Manual of Mental Disorders (DSM-IV-TR)

under the heading of “Other Conditions That May Be a

Focus of Clinical Attention.” Although abuse was first

defined with regard to children when it first received sustained

attention in the 1950s, clinicians and researchers

now recognize that adults can suffer abuse in a number of

different circumstances. Abuse refers to harmful or injurious

tlude not

only the direct costs of immediate medical and psychiatric

treatment of abused people but also the indirect

costs of learning difficulties, interrupted education,

workplace absenteeism, and long-term health problems

of abuse survivors.

Types of abuse

Physical

The Abnormal Involuntary Movement Scale (AIMS)

is a rating scale that was designed in the 1970s to measure

involuntary movements known as tardive dyskinesia

(TD). TD is a disorder that sometimes develops as a

side effect of long-term treatment with neuroleptic

(antipsychotic) medications.

Purpose

months to monitor the patient for the development of TD.

For most patients, TD develops three months after the initiation

of neuroleptic therapy; in elderly patients, however,

TD can develop after as little as one month.

Precautions

The AIMS test was originally developed for administration

by trained clinicians. People who are not health

care professionals, however, can also be taught to administer

the test by completing a training seminar.

Description

The entire test can be completed in about 10 minutes.

The AIMS test has a total of twelve items rating

involuntary movements of various areas of the patient’s

body. These items are rated on a five-point scale of severity

from 0–4. The scale is rated from 0 (none), 1 (minimal),

2 (mild), 3 (moderate), 4 (severe). Two of the 12

items refer to dental care. The patient must be calm and

sitting in a firm chair that doesn’t have arms, and the

patient cannot have anything in his or her mouth. The clinician

asks the patient about the condition of his or her

teeth and dentures, or if he or she is having any pain or

. Again the rater observes the

patient’s face and legs for any abnormal movements.

After the face and hands have been tested, the patient

is then asked to flex (bend) and extend one arm at a time.

The patient is then asked to stand up so that the rater can

observe the entire body for movements. Next, the patient

is asked to extend both arms in front of the body with the

palms facing downward. The trunk, legs and mouth are

again observed for signs of TD. The patient then walks a

few paces, while his or her gait and hands are observed

54. Mantra Raj

55. Kuvichka Tantra

56. Vigyan Lalitka Tantra

57. Lingagam Tantra

58. Kalotarr Tantra

59. Brahm Yamal Tantra

60. Aadi Yamal Tantra

61. Rudra Yamal Tantra

62. Brihdhamal Tantra

63. Siddh Yamal Tantra

64. Kalp Sutrah Tantra

(sometimes called a “bong”) and smoked. An alternative

method of using marijuana involves adding it to foods

and eating it, such as baking it into brownies. It can also

be brewed as a tea. Marijuana has appeared in the form

of “blunts”—cigarettes emptied of their tobacco content

and filled with a combination of marijuana and another

drug such as crack cocaine.

Between 1840 and 1900, European and American

medical journals published numerous articles on the therapeutic

uses of marijuana. It was recommended as an

appetite stimulant, muscle relaxant, painkiller, sedative,

and anticonvulsant. As late as 1913, Sir William Osler

recommended it highly for treatment of migraine. Public

opinion changed, however, in the early 1900s, as alternative

medications such as aspirin, opiates, and barbiturates

became available. In 1937, the United States

passed the Marijuana Tax Act, which made the drug

essentially impossible to obtain for medical purposes.

By the year 2000, the debate over the use of marijuana

as a medicine continued. THC is known to successfully

treat nausea caused by cancer treatment drugs,

stimulate the appetites of persons diagnosed with

acquired immune deficiency syndrome (AIDS), and possibly

assist in the treatment of glaucoma. Its use as a

medicinal agent is still, however, highly controversial.

Even although the states of Arizona and California

passed laws in 1996 making it legal for physicians to prescribe

marijuana in the form of cigarettes for treatment of

the diseases listed above, governmental agencies continue

to oppose strongly its use as a medicine, and doctors

who do prescribe it may find their licenses at risk.

Cannabis-related disorders reflect the problematic

use of cannabis products to varying degrees. These disorders

include:

• Cannabis dependence: The compulsive need to use the

drug, coupled with problems associated with chronic

drug use.

• Cannabis abuse: Periodic use that may cause legal

problems, problems at work, home, or school, or danger

when driving.

• Cannabis intoxication: The direct effects of acute

cannabis use and reactions that accompany it such as

feeling “high,” euphoria, sleepiness, lethargy, impairment

in short-term memory, stimulated appetite,

impaired judgment, distorted sensory perceptions,

impaired motor performance, and other symptoms. with increasing prevalence of obesity more children are now presenting

with type 2 diabetes, particularly from ethnic minorities. In

the USA, in some areas, up to 50% of children with diabetes are

now presenting with the type 2 form.

Latent autoimmune diabetes in adults (LADA) is thought to

comprise about 5% of all patients with type 2 diabetes. These

people have autoantibodies usually seen in type 1 diabetes, but their

clinical presentation is like someone with type 2 diabetes. This is

a group that may present an excellent opportunity for subsequent

prevention of diabetes if an effective intervention can be developed

to prevent further beta cell destruction.

Monogenic diabetes (previously referred

to as maturity onset diabetes in the

young, MODY)

Monogenic diabetes is the term used for a collection of conditions

that cause diabetes now shown to result from single gene

defects. One feature of these conditions is that they show autosomal

dominant inheritance patterns where the disease appears to be

vertically transmitted (e.g. through several generations). It is also

diagnosed before the age of 25 years, but, unlike type 1 diabetes

patients, monogenic diabetes patients do not often require insulin

for at least 5 years after diagnosis. Genetic testing in these cases

can confirm the particular sub-type of diabetes. This can have

significant clinical implications. Patients with HNF1a (hepatocyte

nuclear factor 1a) mutations, for example, exhibit exquisite sensitivity

to sulphonylureas and can be successfully treated with tablets.

Knowledge of the mutation, therefore, can help in the management

of this disorder, even in children who would otherwise have been

put onto insulin. This is also one form of type 2 diabetes where

we would use a sulphonylurea in preference to metformin when

initiating therapy. Patients with HNF1ß have renal cysts. Patients

with glucokinase mutations are less common but the diagnosis is

significant for the individual and their families. Such patients are

much less likely to develop complications of diabetes because they

mainly have mild fasting hyperglycaemia without significant post

meal hyperglycaemia.

Maternally inherited diabetes

with deafness (MIDD)